Team Member Application and Permission to Obtain a background screening

(This form authorizes Osceola Grace Brethren Church to obtain background information and must be completed by the applicant. Completed forms will be retained by the church for a minimum of five (5) years after a background check has been requested.)In the interest of safety and security I, the undersigned applicant (also known as the “consumer”), authorize Osceola Grace Brethren Church through its independent contractor to procure background information (also known as a “consumer report and/or investigative consumer report”) about me, prior to, and at any time during, my service to the organization. This report may include my driving history, including any traffic citations; a social security number verification; present and former addresses; criminal and civil history/records; and the state sex offender records.I understand that I am entitled to a complete copy of any background information report of which I am the subject upon my request to Osceola Grace Brethren Church, if such is made within a reasonable time from the date it was produced. I also understand that I may receive a written summary of my rights under the Fair Credit Reporting Act.

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Applicant *

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Parent/ Guardian in the event the above is a minor *

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By checking the box below, I authorize Osceola Grace to perform the above checks. *